The lead article in today’s New York Times, “Medicare Plan for Payments Irks Hospitals,” describes a predictable chaffing at the bit by hospitals regarding new requirements to make them more efficient and ensure a higher quality of care. President Obama’s healthcare plan will use a new statistic, “Medicare spending per beneficiary,” to determine payment rates, giving a higher percentage to hospitals with the best and most efficient treatment of patients.

The contention raised concerns a provision to track spending on patients for up to 90 days after they leave the hospital. Hospitals claims they have little-to-no control over this time period, and it is unfair for them to be held accountable for it. The reason for the inclusion of this parameter is to encourage better coordination between hospitals and physicians.

In my opinion, the important thing is to establish any sort of payment formula, and it can always be adjusted subsequent to application, if necessary. I’m pretty sure that hospitals would find some other reason to object to this general requirement because, in effect, they don’t like it in the first place.

The idea of giving hospitals “performance scores” is a good one because it makes some attempt to hold off runaway healthcare costs. Again, the important thing is we’re doing something; the details can always be refined.

The lead article in today’s New York Times, “Health Insurers Profit as Many Postpone Care,” makes me glad the Democrats finally passed national health insurance. The nation’s major insurance companies are raising premiums substantially faster than the rate of inflation despite record profits and a decision by many consumers to forego medical treatments they believe are unnecessary.

Many wonder whether the rapid increase in premiums is based on a fear by many insurance companies about the launch of President Obama’s healthcare act, primarily slated to kick in around 2014 or 2015. One of the most expensive provisions, a requirement to cover people despite potentially expensive pre-existing conditions, may be unpredictable in its effect on private insurance companies.

Still today, many people still suffer from high deductibles; 10 percent of people with employer-based coverage are hit with a yearly deductible of $2,000, and, in these uncertain economic times, that is making them think twice about elective procedures, using brand versus generic drugs and even preventive tests such as a mammography or colonoscopy.

Insurers are claiming that they expect patient demand for procedures to increase again later in the year, but noone knows that for sure, and meanwhile these predatory companies are rolling in cash and increasing rates by double digits to boot.

The lead article in today’s New York Times, “As Vowed, House Votes to Repeal Health Care Law,” describes fulfillment of a campaign promise by Republicans but, in reality, demonstrates their fundamental opposition to government intervention on behalf of the poor and suffering.

The article relates background on the 245-to-189 vote, and the Democrats showed surprising unity with all but three voting against the legislation (the turncoats were Dan Boren of Oklahoma, Mike McIntyre of North Carolina and Mike Ross of Arkansas).

The Republicans supposed support of certain planks of the health care bill rings hollow as they’ve never passed health care legislation when they were in power. Of course, the Democrats immediately trumpeted these planks including the prohibition against discrimination based on pre-existing conditions, the ability for children to stay on their parents’ plan until age 26 and the expansion of care to 30 million new people.

The passage of the repeal, of course, is symbolic only as the Senate will not even introduce the legislation, and President Obama would veto it in any case. It does, however, represent an attempt by Republicans to take the offense after the assassination attempt against Gabrielle Giffords. The article notes that this will be followed by very real attempts to limit federal spending.

The lead article in today’s New York Times, “Short of Repeal, G.O.P. will Chip at Health Law,” demonstrates a major character flaw in the Republican Party, they don’t know when to quit. The legislative battle over health care has been waged and won by the Democrats. The Republicans should be gracious in defeat and give the new law a chance to work and let Americans evaluate the results.

Instead, they can’t admit defeat and will work to dismantle the law in every way they know how. This includes preventing money for enforcement, going after specific provisions — such as requiring businesses to pay a tax penalty if they don’t offer insurance to their employees — limiting support of the I.R.S. meant to ensure compliance with the law, and much more.

Of course, the Republicans are ignoring popular provisions of the law such as prohibiting discrimination by insurance companies based on pre-existing conditions, keeping children on their parents’ policies until age 26, removing caps on lifetime benefits and the removal of co-pays for preventative health services. Republicans are also threatening to hold investigations about the new law if they gain the gavel by taking over the House.

This is not the way our politics is supposed to work and brings the meaning of obstructionism to a whole new level. The Republicans had their chance to work with the Democrats to shape the healthcare legislation but they chose not to. They should take their lumps and give the legislation a fair chance to succeed.

The lead article in today’s New York Times, “Health Care Overhaul Becomes the Law of the Land; In the Process, Pushing Back at Inequality,” is a news analysis on the broader themes of healthcare legislation. It looks at the bill’s attack on ecomomic inequality and compares it to the trends since Ronald Reagan took power, that is increasing inequality between the rich and the poor.

The article notes that since the 1970′s, the tax rates of the rich have plumetted while their incomes have grown significantly more than anyone else. The healthcare bill, officially known as the Patient Protection and Affordable Care Act, works in the opposite direction. It assists families with incomes under $88,000 to buy insurance while drawing a large part of its funding from those earning $250,000 a year or more.

In doing so, the article notes, this bill has officially signified the end of the “age of Reagan.” That is a good thing, in my opinion, because the United States is not about a class-based society, and it has always been best for our self-image when a rising tide lifts all boats, not leaving major groups of people behind.

Of course, much of the above observations are symbolic. There will be no sudden wrenching of our society, and the sky will not fall as some Republicans would have us believe. This healthcare legislation is more about hope than anything else and a vision for the future.

The lead article in today’s New York Times, “Congress Sends White House Landmark Health Overhaul,” describes, with banner headlines, the victory for the Democrats in the House of Representatives last night.

The riveting proceedings, and the final vote, fell into place after Bart Stupak, and his newly empowered pro-life wing of the Democratic Party, agreed to support the legislation thanks to a promise by President Obama to issue an executive order reaffirming the Hyde Amendment, that no taxpayer funds would be used for abortions.

Though this blog has adopted a somewhat neutral stance since its inception, I must applaud the Democrats, and especially Nancy Pelosi and President Obama, for their perseverance and determination to see through this fight to its conclusion.

The Republicans, though understandably differing on the role of government, have not conducted themselves in an honorable mannner, and their continuing threats reflect poorly on their Party. Their alliance with the Tea Party and some of its tactics are even worse.

Nancy Pelosi, though not a sparkling speaker, is a superb Speaker. Her handling of the House Democratic Caucus showed finesse, understanding and an ability to work with people to address their heart-felt concerns.

Her march with fellow Democrats to the Capitol yesterday afternoon went beyond political theater to show a common purpose and defiance of the thuggery of the demonstrators attempting to stand in her way.

Kudos to Pelosi Power and God Bless America.

The lead article in today’s New York Times, “Democrats Woo Foes of Abortion for Health Vote,” describes the continuing wrangling to secure 216 votes in the House of Representatives to finally pass President Obama’s national healthcare legislation.

And if they suceed, it will be exactly that, President Obama’s victory. For even though he only gave guidance to the House and Senate during the legislative drafting process, it has only been through his perseverance that we have reached this stage.

Our representatives were giving up healthcare for dead after the election of Scott Brown as Senator in Massachusetts, and the loss of the Democratic supermajority in the Senate.

But through a clever series of events and timing, the President nursed the healthcare debate back to life, cleverly playing off Republican intransigeance during his summit at the White House, and then using that summit as a springboard to the current final push.

The article in the Times lists additional “yes” votes and even notes the possible placation of Bart Stupak and other conservative Democrats to go over the top. But for those who doubt the final result, you must remember that Nancy Pelosi, one of the strongest and most talented Speakers of the House in recent memory, almost always succeeds.

We can only pray she does so on Sunday, too.

The lead article in today’s New York Times, “Democrats Gain with a Promise on Health Costs,” describes the continuing momentum in favor of national healthcare passage. With 72 hours to go before a crucial House vote, the Congressional Budget Office offered its non-partisan analysis of the bill — it will reduce the deficit by $138 billion over the next decade.

Another development described in the article was President Obama’s decision to postpone a trip to Asia in order to shepherd the healthcare legislation through to completion. This, too, represented a wise decision given the importance of the bill to the future of his Presidency.

Republicans, of course, are continuing their obstructionist ways, and, at this point, noone really cares about them any more. They had a chance to participate constructively in this historic legislation and chose not to do so for political reasons.

And, in my opinion, the fact that they made the choice for politics, instead of what’s right and wrong for 30 million uninsured Americans, will catch up to them, sooner rather than later.

Meanwhile, with a vote planned for Sunday, Speaker of the House Nancy Pelosi is working furiously to lock up the needed votes. She will get them because of her perseverance and very talented handling of the Democratic caucus. And the American people will benefit as a result.

The lead article in today’s New York Times, “Showdown Near, Health Overhaul Gains Two Votes,” describes new progress by Democratic leaders in obtaining support for national healthcare legislation.

Dennis Kucinich, a longtime liberal holdout, is now supporting the bill despite prior reservations that it didn’t go far enough. Mr. Kucinich, who favors a single payer government plan, will give cover to any liberals in the House with similar reservations.

Even more encouraging, Dale Kildee of Michigan, part of the former Stupak bloc with concerns about abortion language in the bill, now supports the legislation after careful review of the wording. He believes the legislation upholds the Hyde Amendment, which prohibits the use of federal taxpayer funds to support abortion.

In addition, a new major group of nuns also announced support for the legislation for similar reasons.

This is all very encouraging. Following the twists and turns of the healthcare debate over the past year has been an anxiety-producing exercise, especially for a proponent rooting for its progress. The ability of Democrats to put aside their differences and work together for a common cause has been in doubt almost since the start.

Now, however, with the final denouement approaching, there is reason for hope. Still hope, not a certainty, but it’s better than the day after Scott Brown’s election when the enterprise was given up for dead.

The lead article in today’s New York Times is titled, “Obama to Seek Federal Power Over Insurers.” It describes a new item included in a comprehensive health plan from the White House regarding the power to regulate rate increases by healthcare insurers.

The proposal comes in advance of the healthcare summit at the White House on Thursday and, according to the article, makes it difficult for the Republicans to oppose without revealing corporate support for healthcare providers over the general public.

Obama’s panel would be called the Health Insurance Rate Authority and would include participants in a variety of industries including insurance executives, medical groups, economic experts, etc.

Meanwhile, other developments in the healthcare debate include a petition started by liberals in the Senate to reintroduce a public option into any new legislation. Senate Majority Leader and President Obama have sidestepped the issue, waiting to see how many Senators sign the document.

Another possiblity on the horizon remains the use of reconciliation to pass major elements of healthcare legislation. This may become even more likely if Republicans seem recalcitrant or posturing during the healthcare summit.

In my opinion, President Obama is going to come through this with flying colors. He’s had a bad freshman year, but one thing different about President Obama compared to President Bush — he learns from his mistakes. 

Based on his approach with the summit, I think President Obama will stick with this and that something major will pass and be signed into law.