But possible solutions have not evolved either, in part because new proposals seldom build on old ones. Obama’s broad, leave-the-details-to-Congress proposal has little in common with the 1,300-page measure President Bill Clinton couldn’t even get to a vote in a Democratic Senate in 1993.
The Obama strategy was designed to avoid mistakes Clinton made in confronting Congress with a massive bill written in the White House under the management of Hillary Rodham Clinton and essentially telling the House and Senate to take it or leave it. Clinton threatened to veto any bill that did not deliver universal health care. He got nothing to veto.
The Obama team missed part of the lesson when the president pressed for passage of House and Senate bills before Congress took its summer vacation so that they could negotiate a final version when they reconvene in September. What he got was narrow committee approval in the House, a preface to debate and action after Labor Day. In the Senate, the Finance Committee was trying to meet a Sept. 15 deadline to deliver its bill.
Obama’s push for action before the summer recess created a goal the Democrats couldn’t meet and a psychological setback he didn’t need to risk. He now says that it was no big deal and that what he wants is a reform law by the end of the year, to get all Americans insured and curb medical costs.
That is a big deal, underscored by his aggressive television and traveling campaign to try to build public support — and pressure in Congress — to enact health care overhaul this time.
“Now is the hard part — because the history is clear — every time we come close to passing health insurance reform, the special interests fight back with everything they’ve got,” Obama told a town hall in Portsmouth, N.H., on Tuesday. “They use their influence. They use their political allies to scare and mislead the American people. They start running ads. This is what they always do.”
Short of it, he and the Democrats could have a major political burden going into the 2010 congressional elections, just as Clinton did when Democrats lost the 1994 elections after his health care failure.
An issue that affects all Americans, their doctors, insurers and employers is bound to carry political risk.
Franklin D. Roosevelt wanted national health insurance but, even with his power in the New Deal Congress, he did not dare to tie it to Social Security in 1935 lest he lose the whole program. Harry S. Truman pushed it on a Congress that wouldn’t buy it.
While Dwight D. Eisenhower balked at national insurance, he tried to get Congress to support a reinsurance program to buttress private insurers and gain coverage for high-risk patients and the needy.
Congress said no, twice.
John F. Kennedy made health care a major issue in his 1960 campaign. He concentrated on what then was called medical care for the aged, a title that wouldn’t play well with the current Medicare set, people now described as senior citizens. He couldn’t get it through Congress.
Lyndon B. Johnson did, but even with his legendary legislative skills and the overwhelming Democratic majorities in Congress after the 1964 elections, it took more than a year of hard, sometimes arm-bending persuasion to get Medicare enacted. It was a hard sell with conservative Democrats, not unlike the problem Obama faces now.
That one major victory for government health insurance was an exception to the pattern of starting each attempt from scratch instead of evolving it from what had gone before. When Johnson signed the Medicare bill in 1965 and gave Truman card No. 1, he traveled to Independence, Mo., to share “this moment of triumph” with the president who had first proposed it 20 years before.
It provided government health insurance at age 65, tied to Social Security. Broader coverage, which FDR, Truman and Johnson all would have liked to gain, was beyond political reach.
Not only for LBJ, but also for Republican Richard M. Nixon, who proposed universal health insurance in 1974, seeking to use employer-based coverage along with federal subsidies so that all Americans would be insured. It was to be done by private insurers, not the government. There was bipartisan support until Watergate intervened.
The political perils of change were dramatized in 1988 after Congress enacted a Medicare overhaul that included prescription drug benefits financed with higher fees on upper-income recipients, who rebelled. They protested, demonstrated and even chased the sponsor, then-Rep. Dan Rostenkowski, D-Ill., to his car. Those changes were repealed the next year.
Prescription drug coverage was added to Medicare in 2003, pushed by President George W. Bush, who claimed it as one of his major achievements in winning re-election. It did not come easily. The administration understated cost estimates by half, and Republican leaders muscled it through the House by one vote. To hold down the cost, they wrote a gap into the coverage.
That may be changed in an Obama health plan. It points to a chronic challenge in health overhaul efforts: the price of change. Covering nearly 50 million uninsured Americans would cost an estimated $1 trillion-plus over the next decade. Obama promised to do it without adding to the deficit. Now he and Congress have to figure out how.

EDITOR’S NOTE _ Walter R. Mears reported on government and politics for The Associated Press for more than 45 years. He is retired and lives in Chapel Hill, N.C.

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Obama struck back at conservative opponents as lawmakers returned home for their August break facing an increasingly rancorous battle over his top domestic legislative priority. A deal on healthcare has yet to be struck in Congress.

“As we draw close to finalizing — and passing — real health insurance reform, the defenders of the status quo and political point-scorers in Washington are growing fiercer in their opposition,” Obama said, without naming names, in his weekly radio and Internet address.

“Some have been using misleading information to defeat what they know is the best chance of reform we have ever had,” Obama said, adding it was critical for Americans to have all the facts as they meet their lawmakers in their home districts.

Obama adviser David Axelrod has coached Senate Democrats on how to deal with angry opponents of the healthcare proposals during a month long August recess.

Obama’s aides and fellow Democrats have charged that protests staged at some “town hall”-style meetings held by congressional Democrats have been orchestrated by Republican- and industry-backed groups and conservative talk-show hosts, and are calling for a more civil dialogue.

Obama’s push for healthcare reform, which seeks to provide coverage to nearly 46 million uninsured Americans, rein in healthcare costs and regulate insurance practices has been assailed by critics over its $1 trillion cost and scope. Republicans call it a government takeover of healthcare that will drive up the deficit.

Democrats who control Congress have feuded among themselves over how to pay for it, and Obama’s public approval rating has slipped as the debate drags on.

Obama says the package is vital to a U.S. economic recovery. No Republicans have backed the proposals being crafted in Congress.

“Let me explain what reform will mean for you. And let me start by dispelling the outlandish rumors that reform will promote euthanasia, cut Medicaid or bring about a government takeover of health care. That’s simply not true,” Obama said in his Saturday address.

“There are those who … are trying to exploit differences or concerns for political gain,” he added.

Obama acknowledged some differences remained to be worked out but insisted that “we are moving toward a broad consensus” and reaffirmed his goal of getting the healthcare revamp enacted by the end of the year.

He will keep up his own public relations offensive on healthcare next week when he holds a town hall meeting in Portsmouth, New Hampshire.

(Editing by Peter Cooney)

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But a curiosity in the bill that’s received little attention is that its ban on federal money for abortions is governed by a regulation that many Democrats, including President Obama, oppose and have vowed to repeal.

According to an amendment to the House bill adopted last week by the Energy and Commerce Committee, the government’s healthcare plan can’t use federal funds for any abortions that are already restricted by the Hyde Amendment, a law that bars Medicaid from using federal dollars for abortions except in the case of rape, incest, or where the life of the pregnant woman is in danger.

Should the Hyde Amendment be repealed, however—a move that many Democrats, including Obama, have said they support—the House bill would permit federally funded abortions in the public health insurance option and in government-subsidized private plans offered through the proposed health insurance exchange. The Hyde Amendment, first passed in 1977, comes up for reauthorization every year as a rider to the appropriations bill for the Department of Health and Human Services.

“In the future, should Congress say it doesn’t need the Hyde Amendment, it would be odd that the only place in which it would apply is in the health insurance plan,” says an aide to Democratic Rep. Lois Capps, who authored the recently adopted amendment outlining abortion coverage. “So we’re saying the health insurance plan follows the same rules as the federal law.”

If the law is changed to allow federally funded abortion through Medicaid, in other words, federally funded abortions would also be allowed through the government-run health insurance plan.

The Capps amendment ties the health insurance plan’s abortion coverage to the Hyde Amendment by stipulating that the plan use federal funds only for abortions that are permitted to receive federal funds by the health and human services appropriations bill in any given year. If the Hyde Amendment is repealed, granting HHS the power to fund abortions, that would give the same power to the health insurance plan.

In his 2010 budget, Obama declined to request the Hyde Amendment’s repeal, disappointing many abortion rights advocates.

But Obama is on record as opposing the Hyde Amendment. “Obama does not support the Hyde Amendment,” an aide in Obama’s presidential campaign wrote in 2007, responding to a questionnaire by an abortion rights group. “He believes that the federal government should not use its dollars to intrude on a poor woman’s decision whether to carry to term or to terminate her pregnancy and selectively withhold benefits because she seeks to exercise her right of reproductive choice in a manner the government disfavors.”

At the moment, there appears to be little Democratic appetite for repealing the Hyde Amendment, lest the effort amp up the culture wars and derail the party’s other legislative priorities. The amendment has passed in various forms for over 30 consecutive years, including times of Democratic-controlled Congresses and presidential administrations, according to the Guttmacher Institute.

Nonetheless, abortion rights opponents say they are worried. Though the Senate passed a Hyde Amendment-like rule for Indian health services in the previous Congress, just nine Democrats supported it. Since then, the Republicans have lost seats in both houses.

“In 2010, when the health and human services appropriations bill comes around with the Hyde Amendment, Obama could say, ‘We’re already paying for elective abortions through public health insurance, so how can I deny this [Medicaid] population?’ ” says Douglas Johnson, legislative director for the National Right to Life Committee. “He will say, ‘How can I renew the Hyde Amendment?’ ”

Recently, Obama seemed to indicate upholding the spirit of the Hyde Amendment in his healthcare plan. “I’m pro-choice,” he told CBS News’s Katie Couric, “but I think we also have the tradition in this town, historically, of not financing abortions as part of government-funded healthcare.”

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B. Braun Medical SA

204, av. du Mal-Juin BP 331,
Boulogne,
92107
France

Tel: 33/1/41105300
Fax: 33/1/41105399
website: http://www.bbraun.com

Bauerfeind France

BP 50258,
Roissy,
CDG,
95957
France

Tel: 33/1/48632896
Fax: 33/1/48632963

Baxter S.A

Avenue Louis-Pasteur Boite Postale 56,
Maurepas,
Cedex,
78311
France

Tel: 33/134/61/5050
Fax: 33/134/61/5025
website: http://www.baxter.com

Baxter S.A.

12 Chemin du Jubin,
Dardilly,
69570
France

Tel: 33/4/72521200
Fax: 33/4/72521209
website: http://www.baxter.com

Baxter S.A.

Etaille,
La Chatre,
36-400
France

Tel: 33/254/062/525
Fax: 33/4/062/500
website: http://www.baxter.com

Baxter SA

6, av. Louis-Pasteur BP 56,
Maurepas,
78311
France

Tel: 33/1/34615050
Fax: 33/1/34615025
website: http://www.baxter.com

Bayer Pharma

13, rue Jean-Jaurès,
Puteaux,
92807
France

Tel: 33/3/86957100
Fax: 33/3/86646505
website: http://www.bayer.com

BD (Becton Dickinson) Consumer Healthcare

2, place Gustave Eiffel,
S.I.L.I.C. 222,
94528 Rungis Cedex,
France

Tel: 33.1.45.12.52.52
Fax: 33.1.46.87.57.56
website: http://www.europe.bd.com
email: Diabetebd-France@europe.bd.com

BD manufactures and sells a broad range of medical supplies, devices, laboratory equipment and diagnostic products.

BD (Becton Dickinson) France

11, rue Aristide Berges,
B.P. 4,
Le Pont de Claix, 38800,
France

Tel: 33.4.76.68.36.36
Fax: 33.4.76.68.34.95
website: http://www.bd.com

BD manufactures and sells a broad range of medical supplies, devices, laboratory equipment and diagnostic products.

Beiersdorf s.a

1, rue des Sources,
Savigny-le-Temple,
77176
France

Tel: 33/1/64873000
Fax: 33/1/64873010
website: http://www.beiersdorf-medical.com/js_menu.html

Belamont Laboratoires

24, rue Erlanger,
Paris,
75781
France

Tel: 33/1/44961313
Fax: 33/1/44961228

Bio Veto Test

28, rue Barthélemy de Don,
Sanary sur Mer,
83110
France

Tel: 33/4/94742124
Fax: 33/4/94347084

Bioderma

75, cours Albert-Thomas,
Lyon,
69447
France

Tel: 33/4/72114800
Fax: 33/4/78538254

Biogen Europe

Le Capitole,
55 avenue des Champs Pierreux,
92012 Nanterre Cedex,
France

Tel: +1 33 1 41 37 95 95
Fax: +1 33 1 41 37 24 00
website: http://www.biogen.com

Biopharma

29, rue du Pont,
Neuilly-sur-Seine,
92200
France

Tel: 33/1/55726000

Bioprojet Pharma

9, rue Rameau,
Paris,
75002
France

Tel: 33/1/47036633
Fax: 33/1/47036630

Biovac

B.P. 61 Angers Technopole,
Beaucouze,
49071
France

Tel: 33/2/41483030
Fax: 33/2/41483494

BL Nutrition

34, bd Haussmann,
Paris,
75009
France

Tel: 33/1/45258338

Blédina SA

BP 432,
Villefranche-sur-Saône,
69654
France

Tel: 33/4/74626364
Fax: 33/4/74626195

Boehringer Ingelheim

Pharmaceutical Production Site,
12, rue Andre Huet – B.P. 292,
51060 Reims CEDEX,
France

Tel: +33/3/26 50 45 45
Fax: +33/3/26 50 45 00
website: http://www.boehringer-ingelheim.fr

Boehringer Ingelheim

Pharmaceutical Production Site,
Zone Industrielle,
B.P. 20,
60190 Estrées St Denis,
France

Tel: +33/3/44 91 51 00
Fax: +33/3/44 41 39 31
website: http://www.boehringer-ingelheim.fr

Boehringer Ingelheim

Chemical Production Site,
LABSO Chimie Fine,
20, rue Jean Duvert – B.P. 7,
33291 Blanquefort CEDEX,
France

Tel: +33/5/56 35 50 50
Fax: +33/5/56 95 26 04
website: http://www.boehringer-ingelheim.fr

Boehringer Ingelheim Headquarters

37/39, rue Boissiere,
75116,
Paris,
France

Tel: +33/1/44 34 65 65
Fax: +33/1/44 34 65 00
website: http://www.boehringer-ingelheim.fr

Boiron

20, rue de la Libération,
Ste-Foy-lès-Lyon,
69110
France

Tel: 33/4/72164000
Fax: 33/4/78596916

Bouteille Laboratoire

7, rue des Belges,
Limoges,
87000
France

Tel:

Bristol-Myers Squibb

La Grande Arche Nord,
Paris-La Défense,
92044
France

Tel: 33/1/40906000
Fax: 33/1/49001451
website: http://www.bms.com
email: infomed@usccmail.bms.com

Bruneau de la Salle (Ets)

20, rue Eugène-Gibez,
Paris,
75015
France

Tel: 33/1/48282022

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At the doctor’s office, you discover you have a minor ulcer likely caused by ibuprofen overuse. The doctor treats you accordingly and tells you it was a close call.

The pharmacist’s insight prevented you from being hospitalized later with a more serious ulcer. By recommending that you see your doctor, she also ensured you received the appropriate treatments for your knee and your stomach aches. You saved money, improved your quality of life and avoided a dangerous medical condition.

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Democrats Push Health Care Plan While Issuing Assurances on Medicare

The outpouring of concern over Medicare came as House Democratic leaders tried to assuage the concerns of fiscally conservative House Democrats who have held up action on health care legislation while they press for changes to reduce the cost of the bill, estimated at $1 trillion over 10 years.

The White House chief of staff, Rahm Emanuel, met Tuesday with the conservative Democrats in the office of Speaker Nancy Pelosi to try to broker a deal that would allow the House Energy and Commerce Committee to approve the legislation this week, before the House is scheduled to begin a monthlong break.

After six hours of intense negotiations, the talks broke up at 9:15 p.m. with no announcement of a deal or an agreement.

A committee vote could give the White House and Congressional Democrats tangible evidence of progress on Mr. Obama’s top domestic priority.

On the other side of the Capitol, a half-dozen members of the Senate Finance Committee reported further progress toward a possible bipartisan compromise, which includes creation of a new federal panel to hold down Medicare costs, particularly payments to hospitals and other health care providers.

But some liberal Democrats, like Senators John D. Rockefeller IV of West Virginia and Debbie Stabenow of Michigan, expressed reservations about concessions being made by Democrats to keep a few Republicans on board.

Mr. Rockefeller said he was unhappy that the legislation would end the Children’s Health Insurance Program and could reduce the scope of benefits for 11 million children in the program.

Asked if he would support the bill, Mr. Rockefeller shot back a somber, stony look. “Can’t you see the joy on my face?” he asked.

Speaking at a town-hall-style meeting organized by AARP, Mr. Obama said his proposals would slow the growth of health spending and avoid the need for future cuts in Medicare, the insurance program for 45 million people who are 65 and older or disabled.

Democrats in Congress plan to finance about half the cost of the legislation by squeezing savings from Medicare. The White House says benefits will not be cut and beneficiaries will not be hurt.

“Nobody is talking about cutting Medicare benefits,” Mr. Obama said.

But Representative G. K. Butterfield, Democrat of North Carolina, said he heard many expressions of concern from constituents when he answered telephone calls to his office on Tuesday.

“The longer we wait to vote,” Mr. Butterfield said, “the more opportunity our opponents have to put out false messages. Seniors fear they will lose Medicare. They worry they will have to discuss plans for end-of-life care every five years.”

A provision of the House bill would provide Medicare coverage for the work of doctors who advise patients on life-sustaining treatment and “end-of-life services,” including hospice care.

Conservative groups have seized on this provision as evidence that the bill could encourage the rationing of health care. The Family Research Council, for example, said the bill would “limit end-of-life care.”

The House Republican leader, Representative John A. Boehner of Ohio, said, “This provision may start us down a treacherous path toward government-encouraged euthanasia.”

Representative Robert E. Andrews, Democrat of New Jersey, said, “I have met seniors who think their Medicare will be taken away, which is false.”

Lawmakers on both sides of the Capitol struggled Tuesday to come up with a bill that would cover the uninsured and control costs.

In the House, the fiscally conservative Democrats — members of the Blue Dog Coalition — said they were not satisfied with the offers made Monday by the chairman of the Energy and Commerce Committee, Representative Henry A. Waxman, Democrat of California. They drafted a counteroffer.

House Democrats said their bill included provisions that would help older Americans. For example, they said, the bill would gradually close a gap in Medicare coverage of prescription drugs known as a doughnut hole. It would eliminate co-payments and deductibles for most preventive services in Medicare and make it easier for low-income people to get help with the cost of their Medicare premiums.

The House bill would cut more than $160 billion over 10 years from the projected growth of Medicare payments to insurance companies that manage care for more than 10 million of the 45 million Medicare beneficiaries.

“We’ll eliminate billions in unwarranted subsidies to insurance companies in the Medicare Advantage program — giveaways that boost insurance company profits but don’t make you any healthier,” Mr. Obama told AARP members.

But Robert E. Zirkelbach, a spokesman for America’s Health Insurance Plans, a trade group, said that if Congress made those cuts, “beneficiaries would face higher premiums and reductions in benefits, and in some parts of the country, they might lose access to their Medicare Advantage plans.” When Congress cut Medicare payments in the past, he said, insurers withdrew from some counties.

Carl Hulse contributed reporting.

Democrats Push Health Care Plan While Issuing Assurances on Medicare is a post from: Pharmacy in jobs, news, schools

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