By Ricardo Alonso-Zaldivar

Medical researchers and politicians are tiptoeing into an area of health care that makes some Americans uncomfortable, even angry, and it has nothing to do with such hot-button issues as cloning and stem-cell research. This time, the idea is to press doctors and patients to use particular drugs and treatments in order to save money.

On the surface, it seems simple enough: Billions of dollars could be saved if everyone adopted the regimens that research showed were best and most cost-effective - which, experts say, happens far less often than most patients think.

The problem is that any move to push doctors and patients to make a particular choice collides with the American belief that medical decisions are nobody's business but the patient's and the doctor's. Least of all, the government's.

Also, because the research is based on statistical analyses and there are trade-offs in almost all medical choices, there's sometimes room to disagree about what constitutes the "best practice."

Yet scientists, medical-policy specialists and leading politicians are starting to embrace the idea of using cost-effectiveness research to drive individual medical decisions. They call it "comparative effectiveness" research, sidestepping a direct reference to costs.

Democratic presidential candidate Barack Obama of Illinois is calling for substantial investment in the idea. And Republican candidate John McCain is interested.

Read the full story in the Los Angeles Times.

by Matthew Hay Brown

Sen. Edward M. Kennedy has left Duke University Medical Center a week after undergoing surgery for a cancerous brain tumor.

"His doctors are pleased with his progress since surgery a week ago, and he will continue to recuperate at home before starting the next phase of his treatment," his office said in a statement. "He is thankful for the extraordinary care of the doctors and nurses at Duke, and also for the continued prayers and well wishes from the people of Massachusetts and all over the country."

The Massachusetts Democrat returns to Hyannisport, Mass., where he suffered the seizure last month that led doctors to diagnose him with a malignant glioma. His surgeon at Duke said today that Kennedy was making an "excellent recovery."

"He will continue his recuperation at home in Massachusetts under the supervision of the very capable doctors at the Massachusetts General Hospital," Allan Friedman said in a statement.

Kennedy's son said his father, who chairs of the Senate Committee on Health, Education, Labor and Pensions, was eager to get back to work on legislation to provide universal health insurance.

"It adds a great deal of poignancy to his recovery," Rep. Patrick Kennedy, a Rhode Island Democrat, told the Providence Journal on Sunday. "But that's how he sees it, he has to recover so he can get healthcare for the millions of people who don't have access to the care that we do."

Patrick Kennedy said his father wanted to begin work on the legislation this fall so that "it can be ready when Obama takes over in January."

by Bay Fang

Secretary of State Condoleezza Rice opened the 26th annual Susan G. Komen Race for the Cure this mornng with a sly joke that must have had gossip columnists momentarily salivating.

"There is a very important man in my life," she said, standing on a stage near the National Mall above a throng of tens of thousands of people wearing pink. "He is my personal trainer, Tom."

With that, she introduced Thomas Tomlo, who also acts as a fitness advisor to the Race for the Cure, who led participants in a warm-up stretch.

The cause, however, is no joke for Rice or the millions of others who run, walk or sleep in every year to raise money for breast cancer research and public health programs. Rice's mother, Angelena, was diagnosed with breast cancer in 1969, and died in 1985.

Rice, who travels next week to Paris and the Middle East, shared the stage with Ambassador Nancy Brinker, a breast cancer survivor and founder of the Race for the Cure, Sex and the City star Cynthia Nixon, and DC mayor Adrian Fenty. The event in DC, which has one of the highest breast cancer mortality rates in the US, drew nearly 50,000 people.

by David Nitkin

The economy and the Iraq War may be the top concerns of voters this election year, but the cost and availability of health care is close behind.

It's an issue regularly discussed on the campaign trail, and the next president is likely to seek significant changes in the way health care services are delivered and paid for.

Democrat Barack Obama advocates a universal health care program for children, and increased affordability for all. Republican John McCain wants to shift the tax treatment of health care premiums so that employers and the government are no longer the main providers of coverage. He wants to tap into free-market forces to drive prices down and encourage the uninsured to purchase private health insurance.

During the last major national health reform effort, in 1993 and 1994, many interest groups worked to thwart the efforts of then-First Lady Hillary Clinton and the Clinton administration. Notably, the Health Insurance Association of America developed the devastatingly effective "Harry and Louise" advertising and lobbying campaign, portraying a middle-aged couple worrying that the government was going to take over their health care.

This year, the association of private insurers is trying a different approach. They - and other groups of doctors, hospitals and think tanks - want to be part of the dialogue, earlier on today, America's Health Insurance Plans (formed in 2003 by a merger of HIAA and another group) released a study concluding that a series of sensible reforms could yield $145 billion in health cost savings by the year 2025.

Sen. Edward M. Kennedy leaves Massachusetts General Hospital in Boston, Wednesday morning, May 21, 2008 with his wife, Vicki, right, and niece Caroline Kennedy Schlossberg, center right. (AP Photo/Stephan Savoia)

by Jill Zuckman

Sen. Edward M. Kennedy left Massachusetts General Hospital in Boston a few minutes after 10 a.m. today accompanied by his wife, children and niece, Caroline Kennedy. He was greeted by his two Portuguese water dogs, who were waiting outside.

A bandage on the back of his head was visible from the biopsy that was performed to reveal he has a malignant brain tumor. He got into his S.U.V., put his seat belt on and left for his home in Hyannis Port.

"Senator Kennedy has recovered remarkably quickly from his Monday procedure and therefore will be released from the hospital today ahead of schedule," said a statement from his doctors. "He will return to his home on Cape Cod while we await further test results and determine treatment plans. He's feeling well and eager to get started."

In an email to friends and family obtained by the Associated Press, Vicki Kennedy said the diagnosis had thrown them "a real curveball."

"Teddy is leading us all, as usual, with his calm approach to getting the best information possible," she wrote.

"He's also making me crazy (and making me laugh) by pushing to race in the Figawi this weekend," she wrote. The Figawi is an annual sailing race from Cape Cod to Nantucket.

by Jim Tankersley

PORTLAND, Ore. - A subdued but resolute Sen. Hillary Clinton returned to her signature issue and a long-debated contrast with Democratic rival Barack Obama in a brief Oregon campaign stop today.

Clinton used a trip to Doernbecher Children's Hospital, in the hills on the west bank of the Willamette River, to re-stake her campaign as a crusade for health care for all Americans - and to reframe the Democratic race as a choice between a candidate who will achieve universal coverage and one who won't even try.

"If you don't start in favor of universal health care, you're never going to get there," Clinton said at the outdoor hospital courtyard event. "How can anybody run to be the Democratic nominee for president and not have a universal health care plan? This is a huge difference."

The New York senator called universal coverage a moral and economic imperative for both children and adults, emphasizing a distinction between her plan and Obama's that she has highlighted for months with mixed results.

Clinton's plan would require all Americans to have health insurance. Obama's plan would mandate coverage for all children but not for all adults. The campaigns have clashed over how many people Obama would leave uninsured, and whether Clinton's mandate would truly result in universal coverage.

by Mark Silva

President Bush, releasing the 2008 National Drug Control Strategy today, says the report portrays "hopeful progress... in the fight against addiction.''

With a goal of cutting drug abuse among young people by 25 percent during his two terms, Bush says the administration has focused on interdiction "to keep drugs out of the United States,'' abuse-prevention and education and treatment for "those who've fallen prey.''

"These efforts have produced measurable results,'' he said today, in his weekly radio address. "Since 2001, the rate of youth drug abuse has dropped by 24 percent.''

Ecstasy is off 50 percent, methamphetamines off 64 percent, the report concludes.

Suggesting that the fight is shifting to the abuse of prescription pain-killers and other drugs, including those peddled on the Internet, Bush said: "I'm asking Congress to work with my administration to put an end to the illegal sale of highly addictive prescription drugs on the Internet. By working together to meet this goal, we can ensure a safer future for our children.''

See a summary of the White House report today: Download file

And see the president's address here:

By Matthew Hay Brown

A month ago, Congress voted for the second time this year for a $35 billion plan to extend and expand the State Children’s Health Insurance Program. But still lacking a House majority large enough to override the veto promised by President Bush, the bill’s Democratic managers decided to hold onto it, in hope they could work out a compromise that would gain the necessary support.

Now, with the session winding down and still no deal, they’re going to send it to the White House.

“This legislation, of course, passed the House and Senate with broad bipartisan support, and we urge the President to sign it into law,” House Majority Leader Steny H. Hoyer said in a statement released late Friday. “Our bipartisan discussions on extending health insurance to 10 million children are ongoing.”

The move is intended to make Bush act on the bill before Congress goes home for the year. The Constitution gives the president 10 working days to sign legislation or veto it. If he does nothing, it becomes law without his consent – unless Congress adjourns before the deadline. In that case, legislation that has not been signed or vetoed simply expires.

Congressional leaders are planning to return Monday for two more weeks before breaking for the year. That means it’s now or never for the bill supporters if they want to force presidential action this session.

by Mark Silva

President Bush will celebrate his administration’s commitment to the global fight against AIDS today at a church in Maryland – a symbolic setting for a program that places a lot of faith in the ability of faith-based organizations in Africa and other parts of the world to wage a battle against deadly diseases.

At the Calvary United Methodist Church in Mount Airy, Md., the president and First Lady Laura Bush – who traveled to Africa this year to showcase some of the administration’s work – will meet with members of local churches involved in the fight in AIDS-afflicted nations and faith-based organizations that are working in partnership with the President’s Emergency Plan for AIDS Relief (PEPFAR.)

Critics of the American campaign complain that it has placed too much emphasis on promoting abstinence and fidelity as ways of averting the spread of the HIV virus. Yet the Bush administration points to more than one billion condoms distributed since a program known as “ABC’’ – for Abstinence, Being Faithful and Condoms – since the president first proposed his global initiative in the 2003 State of the Union address.

While Congress has required that one-third of AIDS-prevention funding go toward the promotion of abstinence, prevention accounts for about one quarter of all the $15 billion that the U.S. has committed to the first five years of a program that includes testing for HIV and treatment of AIDS victims with antiretroviral drugs. Bush is asking Congress to double that commitment to $30 billion over the next five years.

The Global Fund to Fight AIDS, Tuberculosis and Malaria today announced that it is supporting life-extending treatments for 1.4 million people living with AIDS and HIV – an 88 percent increase in the past year. The fund draws most of its money from the U.S. contribution.

The fund has delivered anti-TB drugs to 3.3 million and delivered 46 million insecticide-treated bed nets which serve in the prevention of the spread of malaria – that’s a 155 percent increase over last year’s distribution of 18 million nets.

by William Neikirk

Much of the political discussion about Social Security these days concerns how it might be rescued from insolvency. Rarely do you hear that the government's popular retirement program should be expanded.

But in some circles, particularly among those who call themselves progressives (or liberal, if you will), there is increasing talk about enlarging the Social Security program because of perceived inequities in tax-deferred retirement savings like 401(k) plans and individual retirement accounts (IRAs).

One such program was outlined Tuesday by Teresa Ghilarducci, a Notre Dame economics professor for the past 25 years, at an event sponsored by the Economic Policy Institute, a Washington think tank. Like many others, she is concerned that the political discussion today is focused on cutting Social Security.

By Jim Tankersley

Gov. Rod Blagojevich found a warm reception for his plan to provide health care coverage to all Illinois residents this afternoon – not in Springfield, but in Washington.

The Democratic governor’s plan, which failed to pass the Democrat-controlled state Legislature this year, won raves from national labor leaders and a former presidential candidate at the National Press Club this afternoon. “Illinois Covered,” as the proposal is called, would extend coverage to the 1.4 million uninsured Illinois adults -- and reduce premiums for middle-income families and small businesses -- by assessing a payroll surcharge on businesses that don’t offer health benefits to their employees.

Richard Gephardt (D-Mo.), a former House minority leader and presidential candidate, hailed the plan as a model for national universal health care – and the sort of plan that must start in the states, not Congress. The president of the international Laborer’s union, Terry O’Sullivan, called it “a blueprint for all other states to follow.” John Sweeney, president of the AFL-CIO, said Blagojevich “has really taken a great stand here.”

by Mark Silva

Here's a cheerful note from the White House:

"Over half the families in America are not poor.''

That's a good glass half-full way of looking at the debate over health insurance for children. With the president having vetoed -- and having sustained that veto -- a bill offering health care to the children of families living at three times the federal poverty level, the White House maintains it is willing to find more money for health care for lower-income children.

Just not the middle class.

White House reaction to the failed veto override.

by William Neikirk

The House of Representatives refused to override President Bush’s veto of a bill that would have dramatically expanded a child’s health-care bill for children, handing Bush a legislative but perhaps not a political victory.

With the loss, Democrats had the challenge of coming up with an alternative would be acceptable to the White House or continuing the deadlock. One possible outcome could be an extension of the program for the next year without additional money or expanded coverage for children.

The vote was 273-156 in favor of the override, short of the required two-thirds vote.

by Matthew Hay Brown

And the kids keep coming.

First, there were Graeme and Gemma Frost, the Baltimore children who were hospitalized for months after a 2004 car crash, but who have been seen more recently in the company of House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid.

Then came Abby, Josh, Latoya and Kevin, all "vetoed" by President Bush, according to a television advertisement produced this month by liberal groups.

Now meet Bethany Wilkerson, the latest youngster enlisted by congressional Democrats or their allies to help build support for the State Children’s Health Insurance Program. Having suffered from heart failure as an infant, USAction says, the Florida toddler would not be alive today but for the government-funded program for moderate-income families not poor enough to qualifty for Medicaid.

Now Bethany is scheduled to speak at a Capitol Hill rally Tuesday evening, according to a release this morning by Americans United For Change.

by Matthew Hay Brown and David Nitkin

With the chances looking slim that Congress will be able to override President Bush's veto of the State Children's Health Insurance Program expansion this week, leaders on Capitol Hill and at the White House are bracing for a potentially bruising round of negotiations to keep current recipients covered.

The popular program for moderate-income families expires in mid-November, and both sides face pressure to reach a deal that maintains funding. But they remain far apart on the costs of a program that Democrats and some Republicans want to expand by millions of children and tens of billions of dollars.

House Speaker Nancy Pelosi says supporters already have compromised to win bipartisan backing in the House and Senate for the $35 billion expansion approved last month by Congress.

"What we did all agree on is that 10 million children would be covered," Pelosi told reporters last week. "With that as the starting point, we'd be happy to have any conversations, in my view, to insure the 10 million children."

Bush, who proposed a $5 billion expansion, has signaled a willingness to add more money to the program, but nowhere near the amount approved by Congress. White House spokesman Tony Fratto said any compromise would have to involve "a more rational children's health care program -- one that focuses more on poorer children."

See the rest of the story in today's Sun:

by Mark Silva

The pressure on Republican congressmen to either stand by their party's president or override President Bush on his veto of the State Children's Health Insurance Program expansion this week is showing in districts across the country.

In Michigan, Gov. Jennifer Granholm, pictured right, called on the Republican opponents of the measure in her state to stand with the children, not the president. She singled out Republican Reps. Mike Rogers of Brighton, Tim Walberg of Tipton, Joe Knollenberg of Bloomfield Hills and Pete Hoekstra of Holland.

With the measure that Bush has vetoed, and its price tag of $35 billion over five years, Michigan's governor says an additional 80,000 children could find health coverage in her state -- in addition to the 55,000 now covered by the program.

"Those who would vote against it are voting against insuring 80,000 uninsured children in Michigan. And that is a travesty," the governor told reporters last week.

Knollenberg, whose district covers Oakland County, complains that congressional leaders want to pay for the increase with a boost in tobacco taxes. And his office has let the governor's office know, in an email today, what it thinks about the pressure Granholm is applying.

"I voted to create the SCHIP program and support extending it to ensure that no kid receiving coverage today will lose it. But Speaker Pelosi has a bill that expands spending by $35 billion. To pay for the new spending, she raises taxes on tobacco products,'' Knollenberg, pictured right, says in a blog on his office Web-site. "But her financing package only works if 22 million new Americans begin smoking. I am against that. I think the government should be promoting wellness and healthy living, not encouraging more Americans to become smokers.

"Smoking stinks and so does the Pelosi health care bill!'' he says.

See the email his chief of staff, Trent Wisecup, sent to the governor's office today, with a link to the congressman's blog on the SCHIP debate:

Halsey and Bonnie Frost, in front of their Butchers Hill home in Baltimore, have come under fire from conservative commentators for promoting the State Children's Health Insurance Program. Sun photo by Barbara Haddock Taylor .

by Matthew Hay Brown

BALTIMORE -- When Halsey and Bonnie Frost agreed to go public with how the State Children's Health Insurance Program helped them after a car crash left two of their children comatose, the Baltimore couple expected to hear from critics of government-funded health care.

But while the Frosts were helping a bipartisan majority in Congress sell a plan to expand the program, they were not prepared for comments such as this one, posted over the weekend on the conservative Web site Redstate:

"If federal funds were required [they] could die for all I care. Let the parents get second jobs, let their state foot the bill or let them seek help from private charities. ... I would hire a team of PIs and find out exactly how much their parents made and where they spent every nickel. Then I'd do everything possible to destroy their lives with that info."

So has begun the education of the Frosts, the young family of six who volunteered to advocate for the program for moderate-income families - the expansion has been approved by Congress but vetoed by President Bush - and now find themselves the focus of a nasty national debate.

The onslaught began over the weekend, a week after 12-year-old Graeme Frost delivered the Democrats' weekly radio address with a plea to Bush to sign the bill. A contributor to the conservative Web site Free Republic noted Graeme's enrollment in the private Park School and the sale of a smaller rowhouse on the Frosts' block for $485,000 this year and questioned whether the family should be taking advantage of the state program.

That post was picked up by the National Review Online and other Web sites. By Monday, Rush Limbaugh was discussing the family's earnings and assets on the air, and the blogger Michelle Malkin was writing about her visit to Halsey Frost's East Baltimore warehouse and her drive past the family's Butchers Hill rowhouse. Liberal bloggers, meanwhile, were complaining that the Frosts were being "swift-boated."

See the rest of the story in the Sun:

by Mark Silva

Rep. Adam Putnam, a Florida Republican, and Rep. Charles Rangel, a New York Democrat, faced off today over the children's health care bill which President Bush has vetoed.

"The president's position is indefensible,'' Rangel, pictured below, said on CBS's Face the Nation. "If we're looking for a productive, educated future society we have to protect our young people.''

Putnam, left, pointing to the Democrat's interest in overriding the president's veto rather than seeking a compromise on a new health care bill, said: "He's more interested in playing political games than in compromising... It's games like this that is the reason why Congress has a 14 percent approval rating.''

For more, see the debate between Putnam and Rangel over a vetoed bill destined for an override attempt later this month: